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  • Beratung  (1)
  • Intima thickening  (1)
  • Springer  (2)
  • Jena
  • Jena : Thüringer Landesanstalt für Landwirtschaft
  • 2000-2004  (2)
Document type
Publisher
  • Springer  (2)
  • Jena
  • Jena : Thüringer Landesanstalt für Landwirtschaft
Years
  • 2000-2004  (2)
Year
  • 1
    ISSN: 1432-0568
    Keywords: Key words Blood vessel walls ; Intima thickening ; Lamina elastica interna splitting ; Morphology ; Elastin quantification
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Although pre-eclampsia (PE) is often associated with fetal hypoxia, hypertension and/or disturbed function of the fetal circulation, the effect of these altered hemodynamic parameters on the structure and composition of umbilical vessels has not been systematically investigated before. Therefore, this study focuses on PE-associated changes of the elastic fibre system in umbilical cord vessels investigated by light and electron microscopy, immunocytochemistry and biochemistry. In umbilical cord veins, no changes in thickness of the vessel wall or of any sublayer were observed. However, the internal elastic lamina of the veins was split in 80% of the PE-group in contrast to 20% in uncomplicated pregnancies. This effect was significant (α 〈0.01) from 36 weeks of gestation onwards. In umbilical cord arteries, the entire arterial vessel wall was found to be 15% thicker in PE than in uncomplicated pregnancies. The enlargement was caused by an increase of both the tunica intima and tunica media. The thickening of the tunica intima was attributed to a migration of smooth muscle cells towards the endothelium, accompanied by a splitting of the internal elastic lamina. Compared to uncomplicated pregnancies, smooth muscle cells of arteries and veins in PE showed a metabolic activation demonstrated by highly dilated endoplasmic reticulum. A semiquantitative score method as well as a quantitative dot blot assay indicated a PE-associated reduction of elastin expression in the arterial vessel walls. In summary, PE obviously induces a decrease of the elastin content accompanied by a thickening of the vessel wall in umbilical cord arteries. This remodeling of the elastic fibre system, together with an increased migration of smooth muscle cells, might represent part of the functional adaptation system of the umbilical cord arteries on the altered hemodynamic conditions in PE.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1615-6722
    Keywords: Schlüsselwörter Compliance ; Entlassungsmedikation ; Beratung ; Klinischer Pharmazeut ; Key Words Compliance ; Discharge medication ; Counseling ; Clinical pharmacist
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Background: With discharge from hospital, the correct use of his drugs is the responsibility of the patient. The patient's compliance mainly affects the success of therapy. An essential requirement for good compliance is informing the patient properly about the purpose and correct use of his drugs. In the first pilot study in Germany on this subject, we investigated how the additional patient medication counseling by a clinical pharmacist prior to discharge improves the patient's knowledge of his drugs. Study Design: During a 10-week-period, 37 patients were randomly assigned to either an intervention group or a control group. Patients of the intervention group were verbally and in writing informed about the purpose and correct use of their drugs. The effect of the additional counseling was determined in both groups by a questionnaire at the time of discharge and a telephone interview 2 weeks later. Conclusion: Patient medication counseling by a clinical pharmacist prior to discharge improves the patient's knowledge of his drugs as an essential requirement of good compliance. Taking into consideration the economical consequences of noncompliance and the financial problems of the public health system it is advisable to establish this service in German hospitals.
    Notes: Zusammenfassung Hintergrund: Mit der Entlassung aus dem Krankenhaus liegt die Verantwortung für die korrekte Einnahme der Medikamente beim Patienten. Seine Compliance ist entscheidend für den Therapieerfolg. Eine wesentliche Voraussetzung für gute Compliance ist die ausreichende Information des Patienten über Indikation und Einnahmemodalitäten seiner Medikamente. In einer Pilotstudie wurde erstmals für Deutschland kontrolliert untersucht, wie die zusätzliche Beratung des Patienten zu seiner Entlassungsmedikation durch einen klinischen Pharmazeuten das Wissen über seine Arzneimittel beeinflusst. Studiendesign:Über eine Zeitraum von zehn Wochen wurden 37 Patienten in eine Beratungs- und eine Kontrollgruppe randomisiert. Die Patienten der Beratungsgruppe wurden mündlich und schriftlich über Indikation und Einnahmemodalitäten informiert. Der Einfluss der Beratung auf das Wissen der Patienten wurden in beiden Gruppen mit Hilfe eines Fragebogens zum Zeitpunkt der Entlassung und eines Telefonats 14 Tage später untersucht. Schlußfolgerung: Die Beratung von Patienten zur Entlassungsmedikation durch einen Apotheker erhöht das Wissen des Patienten über seine Arzneimittel und damit eine wesentliche Voraussetzung für eine gute Compliance. Unter Berücksichtigung der ökonomischen Auswirkungen der Noncompliance und der begrenzten finanziellen Mittel im Gesundheitswesen ist die Einführung eines solchen Beratungsdienstes in Deutschland sinnvoll.
    Type of Medium: Electronic Resource
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